Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
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J Clin Neurophysiol · Aug 2014
Automated auditory mismatch negativity paradigm improves coma prognostic accuracy after cardiac arrest and therapeutic hypothermia.
EEG and somatosensory evoked potential are highly predictive of poor outcome after cardiac arrest; their accuracy for good recovery is however low. We evaluated whether addition of an automated mismatch negativity-based auditory discrimination paradigm (ADP) to EEG and somatosensory evoked potential improves prediction of awakening. ⋯ This automated ADP significantly improves early coma prognostic accuracy after cardiac arrest and therapeutic hypothermia. The progression of auditory discrimination is strongly predictive of favorable recovery and appears complementary to existing prognosticators of poor outcome. Before routine implementation, validation on larger cohorts is warranted.
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J Clin Neurophysiol · Aug 2014
Intraoperative neurophysiological monitoring in anterior lumbar interbody fusion surgery.
Somatosensory evoked potential (SSEP) and motor evoked potentials (MEP) are frequently fused to monitor neurological function during spinal deformity surgery. However, there are few studies regarding the utilization of intraoperative neuromonitoring during anterior lumbar interbody fusion (ALIF). This study presents the authors' experience with intraoperative neuromonitoring in ALIF. ⋯ Somatosensory evoked potential changes occur relatively, frequently, and intraoperatively during ALIF. No patients with positive intraoperative SSEP changes demonstrated new postoperational deficits. Concurrent fusion of both the L4/5 and L5/S1 levels was significant risk factors for SSEP changes leading to intraoperative alerts. Operative duration and increased blood loss during surgery trended toward but did not reach statistical significance.
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J Clin Neurophysiol · Aug 2014
Viability of intraoperative auditory steady state responses during intracranial surgery.
For intraoperative monitoring of auditory nerve function, the auditory steady-state response (ASSR) analysis may be an alternative to brain stem auditory evoked potentials, offering frequency specificity and short detection times. Clinical studies investigating the viability of ASSR under total intravenous anesthesia have not been performed. ⋯ In conclusion, 90- and 110-Hz ASSR can be reliably detected under total intravenous anesthesia. Our results are in line with those from previous studies in awake patients. Auditory steady-state response during anesthesia may enable intraoperative frequency-specific audiometry and monitoring of the auditory nerve.
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J Clin Neurophysiol · Jun 2014
Comparative StudyApplication of subhairline EEG montage in intensive care unit: comparison with full montage.
Problems with the availability of standard EEG monitoring in the intensive care unit have led to the use of recordings that have limited spatial coverage. We studied the performance of limited coverage EEG compared with more traditional full-montage EEG. ⋯ The subhairline montage shows excellent specificity for detecting patients with seizure activity but has limited sensitivity. It has relatively poor performance for other EEG phenomena, but further applications in trending and assessing reactivity should be assessed in further studies.
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J Clin Neurophysiol · Jun 2014
Case ReportsSimultaneous recording of EEG and electromyographic polygraphy increases the diagnostic yield of video-EEG monitoring.
To investigate the usefulness of adjunctive electromyographic (EMG) polygraphy in the diagnosis of clinical events captured during long-term video-EEG monitoring. ⋯ The information obtained from surface EMG recordings aided the diagnosis of clinical events captured during video-EEG monitoring in 7.5% of the total cohort. This study suggests that EEG-EMG polygraphy may be used as a technique of improving the diagnostic yield of video-EEG monitoring in selected cases.